So I shook my head decidedly. “I won’t bother her. And anyway, she may be out.”
Davies looked worried. “She told me to tell you she’d be in, when she went off. You were still in with that D and C, and she didn’t want to bother you. But she said if anything big came up, you should call her - “
But I had made up my mind. “I can manage,” I said, with more bravado than I felt. “Get the main theatre set up as fast as you can. I’ll get out the instruments.”
As I piled instruments into the sterilizer, I felt a little guilty. If Sister had left a message like that, she would be furious if I ignored it. But if everything went well, she couldn’t say much. Everything had to go well. It had to.
I was already scrubbing and counting out the tiny brain swabs when Peter arrived. He raised an enquiring eyebrow at me over his mask, as he, too, started to scrub.
“This will be tricky, Avril,” he said above the splash of the water, soaping his hands and arms vigorously. “Isn’t Sister available?”
“She’s off duty,” I said mendaciously. “Don’t you think I can cope?”
“I’m sure you can.” His eyes crinkled in a smile. “But it won’t be easy. He’s pretty smashed up - “
He was indeed. They brought him straight into theatre, and put him on the table. He was deeply unconscious, and breathing stertorously and unevenly. The anaesthetist wheeled his machine in, and turned on the oxygen, nodding briefly at Peter as he did so.
“No anaesthetic to start?”
Peter nodded. “Better not. There must be a hell of a big clot on the brain somewhere. Just be ready to give him a whiff once I get to it. If I do get to it - “
The theatre porter started to shave the man’s head. They had left it to us, because the Casualty department was so overrun with injured people from the crash - it had been a multiple one, involving three cars and a lorry, as well as this man’s motor bike.
It was a difficult task, but eventually we could see the extent of the man’s injuries. It was as though a playful giant had tapped him with a monster egg spoon. A round section of his skull had been shattered, and I could see splinters of bone pointing inwards towards his brain. If this man survives, I thought, fighting down a wave of nausea, it will be a miracle. I wished desperately that I had called Sister. But it was too late now.
We towelled up, and started. Delicately Peter removed the splintered bone, until the torn meninges - the brain covering - lay revealed under the big shadowless light. I held the sucker carefully, trying to keep the area clean without getting in Peter’s way, but it was difficult because my hands were shaking.
Peter swore under his breath, and took the sucker from my hand impatiently. “Here,” he said briefly, “hold this instead,” and put a bone retractor into my hand instead. I wished he had an assistant, but I supposed that all the other men were too busy in Casualty. I wished again for Sister. She would have known what to do - and her hands never shook.
Peter’s smoothly gloved fingers moved with perfect precision. Gradually, the surface of the brain came into view, and I could see the big dusky clot of blood that was pressing on its grey convolutions, the clot that would kill this man if it wasn’t removed soon. Gently, millimetre by millimetre, Peter eased it away.
Under the towels, the man began to move a little.
“Good man - “ the anaesthetist grabbed for his oxygen tube, making sure the gas was running well. “You’re getting it - “
“Hold him, for God’s sake,” Peter spoke through clenched teeth. “Not much more. Then you can give him a whiff.”
He worked on, his back bent in total concentration as he tried to differentiate between the clot that must be removed, and the tissues that must on no account be pulled on, in case further tearing complicated an already desperate injury.
The remainder of the clot came free at last, and then the patient started to get really restless. His leg jerked, pulling against the blood drip the anaesthetist had just set up, so that the needle came out of his vein, and blood started to run into his tissues, puffing the flesh round his ankle into an ugly discoloration. The anaesthetist grabbed the bottle just in time before it toppled off its stand, and thrust it at Davies.
“I’ll start now - he needs it. O.K.?” he said.
Peter nodded, his eyes never leaving his work. The tube that was only supplying the oxygen to the man’s lungs was now rapidly connected to the anaesthetic, and Peter and I held on grimly, through the towels, as the man threshed and heaved. It seemed an eternity before the anaesthetic took hold, and the movements stopped.
But the activity we had wanted to see, the activity that would show us that the clot had all gone, had also started his circulation moving more rapidly. Blood started to well up into the wound, slowly at first and then more and more quickly.
Peter thrust his hand out behind him, and I slapped an artery forcep into it. I could see the agony of concentration on his face as he searched for, and finally found, the artery that was pumping blood so freely. I heard the forceps click as he closed them, cutting off the red fountain.
“Quickly!” he called. “Silk suture - quickly - “
I went deathly cold. In the rush of preparing the trolley I had forgotten to put any silk sutures ready. Gut, nylon, thread, - but no silk.
“Nurse Davies,” my voice was thick with urgency. “The drum of silks - over there.” I pointed across the theatre to the little metal drum that held the sutures.
Davies looked round wildly. She was still holding the bottle of blood, and the anaesthetist was too involved with his machine to take it from her.
Peter said again, “Silk! God Almighty - where’s that silk?”
“Coming, sir,” I said automatically. “Davies. Bring the silks!”
She was nearly in tears, and looked appealingly at me.
“I can’t - the blood - “
“Put it down, put it down!” I was almost in tears myself. Davies laid the bottle on the table, propping it up against the patient’s leg, and lurched across the theatre to get the drum. As she scuttled to my side with it, the patient gave one last convulsive jerk, and the bottle flew off the table to land on the floor with a crash. Davies whirled to catch it, and let go of the drum, and that, too, crashed to the floor. The lid flew open and the precious reels of silk spilled out to roll, uselessly, into the spreading pool of blood.
For a second, we stood in frozen silence. I looked up at Peter, misery bringing tears into my eyes. “I’m sorry - “ I faltered.
Peter’s blue eyes were blazing with anger. “I’ll use thread,” he said shortly, “I’ll have to,” and held out his hand for it.
I had thread ready, fine thread, already on a tiny needle, and he took it from my shaking fingers and started his repair. But it was useless. The delicate artery tissue tore as he tried to repair it and I could see sweat running down his forehead as he struggled with it.
Suddenly, Davies was at my side. “Nurse Gardner,” she hissed, “silks - “
I turned to stare almost stupidly at the drum she was holding open. “From the Matty block,” she said.
As I took a reel of silk from the drum, and steadied my hands to thread some on to a needle, I blessed her for her quick thinking. Of course, I should have remembered. They had silk sutures on the labour ward, although they rarely used them. I hadn’t even seen Davies leave theatre to run over to Maternity to get the drum.
Peter took the needle from me without a word, and started his repair again, and this time the job went smoothly.
It was an hour or more later when we finished. I saw the trolley out of the theatre, Davies scurrying along beside it, a blood bottle held high above her head - the anaesthetist had managed to start the drip again - and turned back to the mess in the main theatre. Peter was standing in the middle of the floor, his gown dangling limply from one hand, his face white and tired.
“Peter - “ my voice seemed to come from a long way away. “I’m sorry. About the silks.”
He raised his head and looked blankly at me for a second, and then he smiled. “Not your fault, my dear. It could have happened to anyone. So forget it.” Relief surged up in me, and I drew a deep shuddering breath.
“I should have called Sister, really, I suppose - “ I spoke without thinking.
Peter had started to wash his hands, but he turned sharply to stare at me, the soapy water running unheeded down his forearms.
“I thought she was off duty?”
“She is. But she was in her room. She would have come if I’d asked her to.”
“Why didn’t you?”
“I wanted - to cope by myself. And it was your case, you see. I wanted - I - “ I couldn’t go on.
“My dear girl!” Peter was angry now. “Do you mean to tell me that you decided to take this on just because it was my case? For the love of Mike! This was no time for personal feelings! I should have thought that you, of all people, would realize that!”
“I know,” my voice was barely audible. “I wouldn’t have thought I could let my feelings interfere with my work. But - “ I raised my head and looked straight at him. “I love you. And that means more to me than anything.”
We stood and stared at each other across the brightly lit theatre. I was absurdly aware of the trolley of dirty instruments beside me, of the pool of blood on the floor, of the drum of silk reels yawning open at my feet. There was silence in the theatre. Outside, I could hear Davies clattering dressing bowls as she loaded the sterilizer, and I thought, inconsequentially, “She’s back quickly.” My eyes never left Peter’s face. I could hear my voice echoing inside my head. “I love you.” Had I really said that?
Then Peter came across the floor towards me. The expression on his face puzzled me a little. He looked startled, and oddly ashamed, but somehow pleased with himself.
He rubbed his face with the back of his hand, leaving a wet patch beside his mouth.
“Avril - “ he said, slowly, “Avril, I should - “
Davies came in backwards from the sterilizing room, dragging a bucket of water and a squeegee with her.
“I’d better clean the floor up first, or we’ll be treading gore all over the shop,” she said wearily.
“Yes - do.” Guiltily, I started to clear the trolley, dropping instruments into the handbowl on the stand beside it. Peter stood still for a moment longer, then he turned and went out.
As I cleaned the instruments and sluiced the stained linen, I felt numb. I had still to face Sister in the morning, and when she heard about the silk episode, she would be angry - very angry. And I had told Peter I loved him.
It didn’t seem possible. I had imagined a romantic scene with him many times, a scene in which Peter would tell me first that he loved me, and then I would tell him how I felt. In my fantasies, we had been in a restaurant, or in his car, or in a garden somewhere. But this had happened in a messy operating theatre, and only I had said I loved him.
It took an hour and a half to clean up the mess everywhere. Davies trailed off to bed, her white face pinched with exhaustion. I locked up and followed her down the stairs, walking as quietly as I could in the sleeping hospital. I wondered how the patient was. Would he live? But there was no way of finding out about his condition now. I would have to ask in the morning.
As I passed the male surgical ward, the big swing doors parted, and Peter came out. He hesitated for a moment when he saw me, and then came over to the foot of the stairs.
“Avril,” he said. “I’ve been wondering - “ He stared at me consideringly for a moment, as though he was trying to make some sort of a decision. Then he put his hands on my arms. “Look, my parents have a cottage down at St Margaret’s Bay, in Kent. It’s a bit remote and bleak this early in the year, but,” he smiled warmly, “will you come down there with me for the weekend? Not this next one. I’m on duty - “
I was breathless. “So am I.”
“In two weeks’ time, then. Will you come?”
I nodded, too happy to speak. He looked almost surprised, but then his face cleared, and he leaned forward and kissed me.
“I wish it was tomorrow,” he murmured, and kissed me again, more urgently.
I raised my head after a long pause, and said anxiously, “Peter - that man - will he - is he - ?”
“Still with it - just,” Peter said soberly. “We’ll just have to wait and see, that’s all.”
“Did the delay with the sutures make much difference?”
“No, my dear. Don’t worry about that. It didn’t make the slightest difference. I told you not to worry. You did very well considering you hadn’t done a brain job before - you hadn’t, had you?”
“Did my inexperience show that much?” I asked, a little piqued.
He chuckled. “Only to someone who has had a lot of experience with head surgery - like me.”
“Well, at least I can go to bed without being afraid I’d done so badly I’d contributed to his - death,” I said.
“He’s not dead yet,” Peter was bracing, “so forget it.”
The ward door swished again, and Night Sister appeared, her kindly old face creased with a worried frown.
“Nurse Gardner! You’ve been on duty quite long enough for one day,” she said fussily. “Off to bed with you, at once. I’m sorry the theatre night nurse didn’t come to help to clean up, by the way. The regular girl is off sick, and everyone else was tied up in Casualty. Did you manage all right?”
I smiled at Peter. “Yes, thank you, Sister. I managed quite well, I think.”
I hadn’t even missed the theatre night nurse, I thought in surprise, as I went over to my room. How besotted can you get?
And then I forgot about the case, about everything except that Peter had asked me to meet his parents. I fell asleep with a silly smile on my face. To meet my future in-laws, I told myself drowsily. Nothing could have made it more obvious that Peter loved me. No man takes a girl to meet his family unless he intends to make her a member of that family. “Mrs Peter Chester,” I whispered into my pillow. “Mrs Peter Chester.”
CHAPTER TWELVE
I was a little nervous when I went on duty the next morning. What would Sister say when she heard what had happened last night? But much to my relief, she was quite reasonable about it all. I told her everything, including what had happened with the silk drums; and she listened quietly, without interrupting, before she spoke.
“You should have called me, perhaps, but I suppose you must learn how to cope with every kind of emergency sooner or later. The man is still alive, I understand - I heard all about him from Night Sister this morning. He’s very ill, but that’s to be expected. We can’t tell how severely affected he is until he recovers full consciousness - I gather he’s still in a coma. We must hope for the best, that’s all. But you must learn the correct setting for a decompresson today, Nurse. It was very stupid of you to forget to put out the silks. Before you go off for your weekend, you must set a perfect trolley for me, do you understand?”
I escaped to my morning routine gratefully. To get off with such a mild reprimand was a great comfort. Then I dismissed the whole matter from my mind, and thought instead about Peter’s invitation to meet his parents.
I told Chick about it when we met in the dining room for lunch. She had been too late for breakfast to offer more than a gasped “Hi!” before duty.
“Now perhaps you’ll stop slanging Peter,” I told her triumphantly. “He wouldn’t ask me to meet them if he wasn’t serious about me, now would he?”
“I suppose not,” she said doubtfully. “But all the same, honey, try to keep your head. There’s many a slip and all that.”
“Don’t be such a Jeremiah! As for keeping my head - you aren’t exactly the epitome of sanity yourself, are you? You and your Joe! Up to your eyes in love, and you expect me to be sensible even though I’m in the same state! Have a heart, Chick!” I scoffed.
She relaxed, and started to tell me about the way Joe had played the fool the night befor
e, telling completely strange passers-by, on the way back from the cinema, that “his fiancee beat him regularly,” until we both collapsed in helpless laughter.
I spent the weekend in last minute revision of all the theory we had learned over the past three years, even though I really felt quite confident about the exams.
On Saturday, I got a letter from Susan that made me more determined than ever to try to get the Gold Medal. She told me she had already made the arrangements for my Grad Party. “Because I’m sure you’ll deserve it. I’ve ordered a cake for it with a Gold Medal made of gilded chocolate on the top - I hope you’ll like it. Even Father’s getting interested, now I’ve explained to him about it all. So don’t let us down, will you?”
I wished Susan hadn’t been so premature, but all the same, I felt very happy. For the first time since my mother’s death, I felt I had a family that really cared about me, and what I did. It was an unusual and pleasant feeling.
Monday arrived at last, and I reported to the school with the rest of my set, all of us looking a little strained, and unnaturally neat and tidy.
Before we started on the first paper of the day, the Pawn delivered her usual pre exam speech.
“You will have your State examination tomorrow, both medicine and surgery, and on Wednesday, the hospital viva voce exams, followed on Thursday by the State practical. So you have a heavy week ahead of you. I want you all to make sure you get plenty of rest and recreation in the evenings - and that does not mean staying up till all hours, of course - because there will be no point in last minute studying. If you don’t know what you need to know by now, then you never will. I wish you all the very best of luck.”
By the time Friday came, and the exams were behind us, we were exhausted and dazed. The strain was tremendous, and most of us reacted by getting very short tempered with each other. Jane Mellows, with real venom in her voice, told Barbara Simpson she would personally see that her throat was cut if she, Barbara, didn’t stop sniffing all through the papers, instead of using a handkerchief in a civilized way. At which Barbara promptly burst into tears, which the Pawn managed to staunch before Barbara gave way to real hysterics. As Chick said to me, in an undertone, the Pawn’s face was enough to stop Niagara, when she got really mad.
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